Systemic inflammation after spinal cord injury: A review of biological evidence, related health risks, and potential therapies

Curr Opin Pharmacol, 2022 · DOI: 10.1016/j.coph.2022.102303 · Published: December 1, 2022

Simple Explanation

Chronic traumatic spinal cord injury (SCI) leads to ongoing health issues affecting multiple systems in the body, resulting in illness and disability. Systemic inflammation is linked to many common medical complications and diseases that occur with chronic SCI, suggesting it plays a role in various co-existing pathological conditions. This review describes biological factors contributing to systemic inflammation, affected organ systems, health risks, and potential treatments, highlighting the need for understanding and addressing inflammation in SCI.

Study Duration

Not specified

Participants

Human population and epidemiological studies

Evidence Level

Review

Key Findings

1
Chronic SCI is associated with elevated levels of CRP, a clinical marker of systemic inflammation and cardiovascular disease risk.
2
SCI-related chronic inflammation is associated with secondary health risks in respiratory, gastrointestinal, and urinary systems, as indicated by epidemiological studies.
3
SCI leads to alterations in body composition, including declines in bone and muscle mass and increased adiposity, contributing to obesity and cardiometabolic syndrome.

Research Summary

Chronic SCI results in systemic inflammation, immunosuppression, and multiple organ dysfunction, leading to exacerbated maladaptive responses and increased morbidity and mortality due to chronically acquired diseases. Understanding relationships between factors associated with systemic inflammation in chronic SCI and between systemic inflammation, immunosuppression, and organ system function will provide insight into pathways of disease. Understanding these relationships will also provide insight into the rationale behind novel approaches to prevent illness, morbidity, and mortality in chronic SCI.

Practical Implications

Lifestyle Modifications

Anti-inflammatory diets and regular physical activity/training can reduce key markers of inflammation in individuals with chronic SCI.

Anti-Cytokine Therapies

Targeting TNF-α, IL-1β, and IL-6 may mitigate pro-inflammatory and proatherogenic consequences of SCI.

Emerging Therapeutic Targets

The NLRP3 inflammasome in VAT and pancreas represents a potential therapeutic target for treating chronic low-grade inflammation associated with metabolic disorders and CVD risk in SCI patients.

Study Limitations

1
The mechanisms that promote persistent systemic inflammation and its consequences remain ill-defined.
2
Biological role of cytokines in pulmonary dysfunction have not been directly studied.
3
Additional research is needed to understand whether changes in the microbiota in the GI and urinary systems are pathological and/or contribute to associated cardiometabolic risks.

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